黄帝问于岐伯曰。余闻刺法于夫子。夫子之所言。不离于营卫血气。夫十二经脉者。内属于腑
脏。外络于支节。夫子乃合之于四海乎。岐伯答曰。人亦有四海。十二经水。经水者。皆注于海。
海有东西南北。命曰四海。黄帝曰。以人应之奈何。岐伯曰。人有髓海。有血海。有气海。有水谷
之海。凡此四者。以应四海也。黄帝曰。远乎哉。夫子之合人天地四海也。愿闻应之奈何。岐伯答
曰。必先明知阴阳表里。荣输所在。四海定矣。黄帝曰。定之奈何。岐伯曰。胃者水谷之海。其输
上在气冲。下至三里。冲脉者。为十二经之海。其输上在于大杼。下出于巨虚之上下廉。膻中者。
为气之海。其输上在柱骨之上下。前在于人迎。脑为髓之海。其输上在于其盖。下在风府。(膻叶袒)
夫天主生物。地主成物。是以人之形身。应地之四海。十二经水。然水天之气。上下相通。是
以头气有街。胸气有街。腹气有街。胫气有街。经气上下之出入也。故合人于天地四海。必先明知
阴阳表里。荣输之所在。四海定矣。胃者水谷之海。其输上在气冲。气在腹者。止之背俞。下至足
之三里。是水谷之海。上通于天气。而下通于经水也。冲脉者。为十二经之海。其输上在于太阳之
大杼。下至巨虚之上下廉。而出于胫气之街。是冲脉之外通于天气。而内通于经水也。膻中者。为
气之海。在膺胸之内。宗气之所聚也。宗气流于海。其下者注于
气街。其上者走于息道。故气在胸者。止之膺与背俞。故其输上在背之天柱。前在膺胸之人迎。是
气海之上通于天。而下通于经水也。脑为髓之海。气在头者。止之于脑。故其输上在于其盖。下在督
脉之风府。是髓海之上通于天。而下通于经水也。是十二经脉。应地之十二经水。经水者。皆注于
海。海有东西南北。而海之云气。上通于天。是以人之所以合天地四海也。
黄帝曰。凡此四海者。何利何害。何生何败。岐伯曰。得顺者生。得逆者败。知调者利。不知
调者害。
姚氏曰。人合天地四海。升降出入。营运无息。故得顺而和者。则生利无穷。逆而不调。则败
害至矣。
黄帝曰。四海之逆顺奈何。岐伯曰。气海有余者。气满胸中。 息面赤。气海不足。则气少。
不足以言。
吴氏曰。天地阴阳之道。更相和平者也。故有余不足。皆为之逆。膻中者。宗气之所居。上出于
喉以司呼吸。故气海有余者。气满胸中。气息 乱。气上逆故面赤也。气海不足。则气少。气少故
不足于言。血海有余。则常想其身大。怫然不知其所病。血海不足。亦常想其身小。狭然不知其所病。
吴氏曰。冲脉起于胞中。上循背里。为经脉之海。其浮而外者。循腹右上行。至胸中而散于皮
肤之间。是冲脉之血。充实于周身。故有余则觉其身大。不足则觉其身小。怫然狭然。不知其为何
病也。王芳侯曰血以应水。故有余常想其大。不足则觉其为小矣。
水谷之海。有余则腹满。水谷之海不足。则饥不受谷食。
姚氏曰。胃气有余。故腹胀满。胃气不足。故饥而不受谷食。
髓海有余。则轻劲多力。自过其度。髓海不足。则脑转耳鸣。胫 眩冒。目无所见。懈怠安卧。
姚氏曰。精液补益脑髓。而下流阴股。故髓海有余。则足劲轻健而多力。度、骨度也。髓从骨
空循度而上通于脑。故有余。则自过其度矣。髓海不足。则精液竭。精液者。所以濡空窍者也。是以
耳为之鸣。目无所见。液脱者。
骨属屈伸不利。故胫 而懈怠安卧。
黄帝曰。余已闻逆顺。调之奈何。岐伯曰。审守其输。而调其虚实。无犯其害。顺者得复。逆者
必败。黄帝曰善。
吴氏曰。审其输。则知其四海之通于经。而经俞之外通于气也。调其虚实。则有余不足自和矣。
害谓经气之逆。复则反逆为顺也。
黄帝向岐伯问道:我从老师那里学习了针刺的方法,老师所说的内容,都离不开营气、卫气和血气。那十二条经脉,内部连接脏腑,外部联络四肢关节。老师将它们与“四海”相联系,这是为什么呢?
岐伯回答说:人也有四海,就像地上的十二条河流一样。河流都是汇入大海的。海有东、西、南、北之分,称为四海。
岐伯说:人有髓海(脑)、血海(冲脉)、气海(膻中)和水谷之海(胃)。这四海,是用来对应天地四海的。
黄帝说:老师将人与天地四海相合,道理深远啊!我希望听听具体是如何对应的。
岐伯回答说:必须先明确阴阳表里以及荣穴、输穴的位置,那么四海就能确定了。
黄帝问:如何确定它们呢?
岐伯说:胃是水谷之海,它的输穴上部在气冲穴,下部在足三里穴。冲脉是十二经之海,它的输穴上部在大杼穴,下部出于上巨虚和下巨虚穴。膻中是气之海,它的输穴上部在柱骨上下方,前部在人迎穴。脑是髓之海,它的输穴上部在头顶百会处,下部在风府穴。
天主管万物的生长,地主管万物的成形。因此人的形体身体,对应地的四海和十二条河流。然而水与天的气息,上下相通,所以头部的气有街(通道),胸部的气有街,腹部的气有街,小腿的气有街。这是经气上下出入的表现。所以将人合于天地四海,必须先明确阴阳表里、荣穴和输穴的位置,这样四海就确定了。
胃是水谷之海,其输穴上部在气冲穴。气在腹部的,治疗取背部的俞穴;下部至足部的三里穴。这是水谷之海,上通天气,下通经水。
冲脉是十二经之海,其输穴上部在太阳经的大杼穴,下部至巨虚的上廉和下廉穴,而出于胫气的街道。这是冲脉外通天气,内通经水。
膻中是气之海,位于胸膺之内,是宗气聚集的地方。宗气流注于海,向下注入气街,向上走息道(呼吸之道)。所以气在胸部的,治疗取胸膺部和背部俞穴。因此气海的输穴上部在背部的天柱穴,前部在胸膺的人迎穴。这是气海上通天气,下通经水。
脑是髓之海,气在头部的,治疗取脑部。因此其输穴上部在头顶,下部在督脉的风府穴。这是髓海上通天气,下通经水。
这十二条经脉,对应地的十二条河流。河流都汇入大海,海有东南西北之分,而海上的云气上通于天。这就是人之所以能合于天地四海的原因。
黄帝问:这四海,什么情况下有利,什么情况下有害?什么情况下产生生机,什么情况下导致败坏?
岐伯说:顺应则生,逆乱则败;懂得调摄则有利,不懂调摄则有害。
姚氏说:人合于天地四海,升降出入,运行不息。所以顺应调和,则生机无穷;逆乱不调,则败害到来。
岐伯说:气海有余,表现为气满胸中,面色发红,呼吸急促;气海不足,则气少,说话无力。
吴氏说:天地阴阳之道,相互保持和平平衡。所以有余和不足,都属于逆乱。膻中是宗气居住的地方,向上出于喉咙以主持呼吸。所以气海有余,气满胸中,气息紊乱,气上逆故面色发红。气海不足,则气少,气少故说话无力。
血海有余,则常常觉得自己身体变大,心中烦闷不知哪里生病;血海不足,也常常觉得自己身体变小,心中局促不知哪里生病。
吴氏说:冲脉起于胞中,沿脊柱内侧上行,为经脉之海。其浮行于外的部分,沿腹部右上行,至胸中散于皮肤之间。冲脉的血充实于周身,所以有余就觉得身体大,不足就觉得身体小。心中烦闷局促,不知道是什么病。王芳侯说:血对应水,所以有余常觉得身体大,不足就觉得身体小。
水谷之海有余,则腹部胀满;水谷之海不足,则感到饥饿却不想吃食物。
姚氏说:胃气有余,所以腹胀满;胃气不足,所以虽然饥饿却不接受食物。
髓海有余,则身体轻健有力,超过正常限度;髓海不足,则头晕耳鸣,小腿酸软眩晕昏花,眼睛看不见东西,精神倦怠想躺着休息。
姚氏说:精液补益脑髓,并向下流注于大腿阴部。所以髓海有余,则腿脚劲健轻快而多力。“度”指骨度。髓从骨空循骨度而上通于脑,所以有余,就会超过正常限度。髓海不足,则精液枯竭。精液是濡养空窍的。所以耳朵鸣响,眼睛看不见东西。津液脱失,骨骼关节屈伸不利,所以小腿酸软而精神倦怠想躺着休息。
黄帝说:我已经听说了逆顺的情况,如何调治呢?
岐伯说:仔细审察其输穴,调节虚实,不要犯禁忌伤害正气。顺应的就能恢复,逆乱的必然败坏。
黄帝说:好。
吴氏说:审察其输穴,就知道四海与经脉相通,而经俞之外又通于气。调节虚实,那么有余和不足自然调和。所谓“害”,是指经气的逆乱;“复”,就是使逆乱转为顺调。
Huangdi asked Qibo: I have learned the methods of acupuncture from my teacher. What he said always revolved around Ying (Nutrient) Qi, Wei (Defensive) Qi, and Blood. The twelve meridians connect internally to the Zang-Fu organs and externally to the limbs and joints. How does the teacher relate these to the "Four Seas"?
Qibo replied: Humans also possess Four Seas, analogous to the twelve rivers on earth. All rivers flow into the seas. The seas are divided into East, West, South, and North, hence called the Four Seas.
Huangdi asked: How can the human body correspond to the Four Seas of Heaven and Earth?
Qibo answered: Humans have the Sea of Marrow, the Sea of Blood, the Sea of Qi, and the Sea of Water and Grain. These four seas correspond to the Four Seas of Heaven and Earth.
Huangdi said: The teacher's analogy between humans and the Four Seas of Heaven and Earth is profound. I wish to hear how this correspondence works in detail.
Qibo replied: One must first clearly understand Yin and Yang, Interior and Exterior, and the locations of Ying and Shu points. Then the Four Seas will be established.
Huangdi asked: How are they established?
Qibo said: The Stomach is the Sea of Water and Grain. Its Shu points are located superiorly at Qichong (ST30) and inferiorly at Zusanli (ST36). The Chong Mai (Penetrating Vessel) is the Sea of the Twelve Meridians. Its Shu points are located superiorly at Dazhu (BL11) and inferiorly emerging from Shangjuxu (ST37) and Xiajuxu (ST39). Danzhong (CV17) is the Sea of Qi. Its Shu points are located superiorly above and below the vertebral column, and anteriorly at Renying (ST9). The Brain is the Sea of Marrow. Its Shu points are located superiorly at the crown of the head and inferiorly at Fengfu (GV16).
Heaven governs the generation of things, and Earth governs their formation. Thus, the human physical body corresponds to the Four Seas of Earth and the twelve rivers. However, the Qi of Water and Heaven connects upwards and downwards. Therefore, there is a "Street" (passage) for Qi in the head, chest, abdomen, and lower legs. This represents the entry and exit of Meridian Qi moving up and down. Hence, when correlating humans with the Four Seas of Heaven and Earth, one must first clarify Yin-Yang, Interior-Exterior, and the locations of Ying and Shu points, so that the Four Seas are determined.
The Stomach is the Sea of Water and Grain; its Shu points superiorly are at Qichong. For Qi in the abdomen, treatment targets the Back-Shu points on the back; inferiorly to the foot, it reaches Zusanli. This is the Sea of Water and Grain, connecting upward to Heavenly Qi and downward to the River Waters.
The Chong Mai is the Sea of the Twelve Meridians; its Shu points superiorly are at Dazhu of the Bladder Meridian, and inferiorly at the upper and lower margins of Juxu, exiting through the Street of Qi in the lower leg. This indicates the Chong Mai connects outwardly to Heavenly Qi and inwardly to the River Waters.
Danzhong is the Sea of Qi, located within the chest and sternum, where Zong (Pectoral) Qi gathers. Zong Qi flows into the Sea; its lower part pours into the Qi Street, and its upper part travels along the respiratory pathway. Therefore, for Qi in the chest, treatment targets the chest/sternum area and the Back-Shu points. Thus, the Shu points of the Sea of Qi are superiorly at Tianzhu (BL10) on the back and anteriorly at Renying (ST9) in the chest. This shows the Sea of Qi connects upward to Heaven and downward to the River Waters.
The Brain is the Sea of Marrow. For Qi in the head, treatment targets the brain. Thus, its Shu points are superiorly at the crown and inferiorly at Fengfu (GV16) of the Du Mai (Governing Vessel). This shows the Sea of Marrow connects upward to Heaven and downward to the River Waters.
These twelve meridians correspond to the twelve rivers of Earth. The rivers all flow into the sea, which has directions of East, West, South, and North, and the clouds/mist from the sea connect upward to Heaven. This is why humans correspond to the Four Seas of Heaven and Earth.
Huangdi asked: Regarding these Four Seas, under what conditions is there benefit, and under what conditions is there harm? Under what conditions is there life/generation, and under what conditions is there failure/decay?
Qibo replied: Following harmony leads to life; following reversal leads to decay. Knowing how to regulate brings benefit; not knowing how to regulate brings harm.
Master Yao stated: Humans correspond to the Four Seas of Heaven and Earth, with ascending, descending, entering, and exiting movements operating without cease. Therefore, if one follows harmony and balance, life and benefit are endless. If one is reversed and unregulated, decay and harm will arrive.
Huangdi asked: What are the conditions of reversal and harmony in the Four Seas?
Qibo replied: When the Sea of Qi is in excess, there is fullness in the chest, redness of the face, and rapid breathing. When the Sea of Qi is deficient, there is shortness of breath and insufficient strength to speak.
Master Wu stated: The way of Heaven and Earth's Yin and Yang is mutual peace and balance. Therefore, both excess and deficiency constitute reversal. Danzhong is the residence of Zong Qi, which emerges from the throat to govern respiration. Thus, when the Sea of Qi is in excess, Qi fills the chest, breathing becomes disordered, and Qi rebels upward causing facial redness. When the Sea of Qi is deficient, Qi is scant, leading to insufficient strength to speak.
When the Sea of Blood is in excess, one often feels their body is large, feeling distressed and unaware of the illness. When the Sea of Blood is deficient, one often feels their body is small, feeling constrained and unaware of the illness.
Master Wu stated: The Chong Mai originates in the uterus, ascends along the interior of the spine, and serves as the Sea of the Meridians. Its superficial external branch ascends along the right side of the abdomen, dispersing in the skin of the chest. The blood of the Chong Mai fills the whole body. Thus, excess makes one feel large, and deficiency makes one feel small. Feeling distressed and constrained, one does not know what the disease is. Wang Fanghou said: Blood corresponds to Water; thus, excess makes one feel large, and deficiency makes one feel small.
When the Sea of Water and Grain is in excess, there is abdominal fullness. When the Sea of Water and Grain is deficient, one feels hungry but cannot accept food.
Master Yao stated: Excess Stomach Qi causes abdominal distension and fullness. Deficient Stomach Qi causes hunger without the ability to accept food.
When the Sea of Marrow is in excess, one feels light, agile, and strong, exceeding normal limits. When the Sea of Marrow is deficient, there is dizziness, tinnitus, soreness and weakness of the shins, vertigo, blindness, lassitude, and a desire to lie down.
Master Yao stated: Essence and fluids nourish the brain marrow and flow downward to the inner thighs. Thus, when the Sea of Marrow is in excess, the legs are strong, light, and powerful. "Du" refers to bone dimensions. Marrow flows from the bone cavities along these dimensions to connect to the brain. Thus, excess means exceeding normal limits. When the Sea of Marrow is deficient, essence and fluids are exhausted. Essence and fluids moisten the orifices. Therefore, the ears ring, and the eyes cannot see. When fluids are depleted, the skeletal joints become stiff and difficult to flex and extend, leading to soreness of the shins, lassitude, and a desire to lie down.
Huangdi said: I have heard of the conditions of reversal and harmony. How should they be regulated?
Qibo replied: Carefully observe the Shu points and regulate deficiency and excess. Do not violate contraindications or cause harm. Those who follow harmony will recover; those who follow reversal will fail.
Huangdi said: Excellent.
Master Wu stated: Observing the Shu points reveals how the Four Seas connect to the meridians, and how the meridian Shu points connect outwardly to Qi. Regulating deficiency and excess brings natural harmony to excess and deficiency. "Harm" refers to the rebellion of Meridian Qi. "Recovery" means turning rebellion back into harmony.